Piezoelectric lithotripsy of gallstones.
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Biomedical subjects
Publications and source records attributed to C Ell.
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This report describes a newly developed catheter system with the aid of which the cystic duct and gallbladder can be reliably catheterized, retrograde, via an endoscope. In 8 out of 10 autopsy preparations, transpapillary gallbladder catheterization was successfully achieved, with an average fluoroscopic duration of 12 minutes (range: 4-20 minutes). Neither macroscopic nor microscopic traumatization of the gallbladder was observed. The procedure described in this paper opens up a diagnostic and therapeutic approach to the gallbladder.
Endoscopic retrograde laser lithotripsy of common bile duct stones is a new technique which can be carried out through the endoscope without anaesthesia using ordinary endoscopic equipment. In the method described here a flashlamp pulsed Neodymium YAG laser (wave length 1064 nm) was used. Light energy was transmitted along a highly flexible quartz fibre with a diameter of 0.2 mm. This new technique was used in nine patients with concrements in the common bile duct, which could not be removed with the established endoscopic techniques. In eight of the nine the concrements (maximum diameter 4.7 x 3.1 cm) could be fragmented and in six the fragments could be extracted from the common bile duct. The total energy required was 80-300 J; complications were not observed.
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The results of an international inquiry on palliative laser therapy of malignant inoperable stenoses in the upper gastrointestinal tract are reported. The results of the treatment of a total of 1,359 patients were collected. The data from laser users with experience in more than 50 treated patients (n = 1,184) were analyzed; 68.9% of the tumor stenoses were located in the esophagus, and 55.7% were not passable with the endoscope. The initial treatment was successful in 83.0% and the complication rate was 4.1% (49 of 1,184 patients). The mortality rate was 1.0% (12 of 1,184 patients).
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